Percutaneous Coronary Intervention or Medical Therapy for Chronic Total Occlusion in Older Adults
Authors' conclusion
In older adults, attempted or successful CTO-PCI may be associated with improved QoL and favorable cardiovascular outcomes compared with OMT; however, as these findings are largely derived from observational studies, they should be viewed as hypothesis-generating.
Study context
- Population
- Older adults with coronary chronic total occlusion29 studies (28 observational)
- Participants
- 19,282 adults
- Comparison
- Attempted/successful CTO percutaneous coronary intervention (CTO-PCI) vs optimal medical therapy (OMT)
- Outcome
- QoL, all-cause mortality and CV outcomes
Methodological detailsmeta-regression
- Meta-regression
Pooled result
As reported in the abstract
CTO-PCI vs OMTRelative risk (95% CI)
Cardiac death; attempted CTO-PCI
0.55(0.40–0.76)
All-cause mortality; attempted CTO-PCI
0.61(0.50–0.75)
MACE; attempted CTO-PCI
0.68(0.60–0.78)
Further pooled results
Successful vs failed CTO-PCI
- Only cardiac death and all-cause mortality reduced
Original publication
Percutaneous Coronary Intervention or Medical Therapy for Chronic Total Occlusion in Older Adults. JACC Adv. Published 29 October 2025. doi:10.
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